RSS Feedhttps://10.40.239.129/blogs/rss-feed/Blog RSS Feeden{B1DE56D5-E958-42B4-BA25-CDCA8043E8D1}https://10.40.239.129/blogs/2016/12/what-is-immunotherapy/What is Immunotherapy?<p>By stimulating the immune system, physicians are able to do one of three things:</p>
<ol>
<li>Allow the immune system to work harder in attacking cancer cells</li>
<li>Boost immune system with various man-made components to better fight</li>
<li>Train immune system to only attack cancer cells</li>
</ol>
<p>At Intermountain Healthcare, we currently deliver approved immunotherapies. In addition, we are investing in the future with regard to research and development through the cancer immunotherapy program. &ldquo;A handful of immunotherapies have been approved for years for certain types of cancer,&rdquo; said Dr. Rhodes. &ldquo;However, Intermountain Healthcare has been instrumental in building a program that will provide additional research and clinical trials to cancer patients.&rdquo; </p>
<p>One of the objectives in immuno-oncology is to help tailor more treatment therapies targeted to work with the body&rsquo;s immune system for a positive outcome and provide clinical trial opportunities to as many cancer patients as possible!</p>
<p>For more information, visit&nbsp;<a href="https://intermountainhealthcare.org/services/cancer-care/precision-genomics/" target="_blank">Intermountain Precision Genomics</a>.</p>Wed, 07 Dec 2016 00:00:00 -0700{272CB8C0-082A-41F2-9A35-1B1F6CE40DC0}https://10.40.239.129/blogs/2016/12/sleep-hygiene/What is sleep hygiene and why is it important? <h3>What is sleep hygiene?</h3>
<p>Sleep hygiene is a variety of different practices that are necessary to have normal, quality nighttime sleep and full daytime alertness. The most important sleep hygiene measure is to maintain a regular wake and <a href="http://www.sleepfoundation.org/sleep-news/five-clusters-sleep-patterns" target="_blank" title="sleep patterns">sleep pattern </a>seven days a week. It is also important to spend an appropriate amount of time in bed, not too little, or too excessive. This may vary by individual; for example, if someone has a problem with daytime sleepiness, they should spend a minimum of eight hours in bed, if they have difficulty sleeping at night, they should limit themselves to 7 hours in bed in order to keep the sleep pattern consolidated. </p>
<h3><em>Why is it important</em> to practice good sleep hygiene? </h3>
<p>Sleep hygiene is important for everyone, from childhood through adulthood. A good sleep hygiene routine promotes healthy sleep and daytime alertness. Good sleep hygiene practices can prevent the development of sleep problems and disorders. </p>
<p>Here are seven tips for maintaining healthy sleep hygiene habits so you can wake up each day <a href="https://intermountainhealthcare.org/blogs/2016/02/your-heart-wants-more-sleep">refreshed and energized for the day</a>: </p>
<p><strong><span style="text-decoration: underline;"></span></strong></p>
<p>1. Try to Keep a Regular Bedtime and Wakeup Time Every Day. <br />
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It may sound strange but your body has a master clock. In fact, most of your cells have clock genes. It&rsquo;s like a symphony orchestra in there, only your orchestra has billions of instruments! And when the timing is messed up, things don&rsquo;t work properly, and you won&rsquo;t sleep well. Keep a record of your sleep times<a href="https://intermountainhealthcare.org/blogs/2014/12/survive-the-holiday-marathon-with-sleep">. Most people need 7.5-8 hours of sleep each day for optimal health.</a><br />
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<p>2. <a href="https://intermountainhealthcare.org/blogs/2015/11/wake-up-without-caffeine">Avoid Caffeine</a>, Alcohol, Nicotine, and Other Chemicals that Interfere with Sleep.</p>
<p>Caffeine is a stimulant that can keep you awake. Try to avoid caffeine (found in coffee, tea, chocolate, soda, etc.) for at least six hours before bedtime. Some people are even more sensitive and must avoid it for 12 hours before bedtime. Similarly, smokers should refrain from using tobacco products too close to bedtime, <a href="https://intermountainhealthcare.org/blogs/2016/03/doctor-advice-quit-smoking-dont-start-your-life-depends-on-it">or better yet, quit!</a> Overall, alcohol worsens sleep quality and increases the chances of bad sleep. You may fall asleep faster, but then you will wake up frequently (sleep fragmentation), have trouble sleeping again, and it becomes a vicious cycle.</p>
<p>3. Create a Sleep Promoting Environment.</p>
<p>A quiet, dark, and cool environment can help promote sleep. Try earplugs or a sound machine. Use heavy curtains, blackout shades or an eye mask to block light. Keep the temperature of the room comfortably cool. And make sure your bedroom is equipped with a comfortable yet supportive mattress and pillows. Mattress and pillow technology has improved substantially in the past few years so it might be time to do some shopping! It may help to limit your bedroom activities to sleeping <a href="https://intermountainhealthcare.org/blogs/2016/07/video-game-addiction-growing-health-problem-for-men">by keeping computers, TVs</a>, and work materials out of the room. <br />
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<p>4. Establish Some Relaxing Activities Before you Go to Sleep.</p>
<p>Ease the transition from wake time to sleep time with a period of relaxing activities 30-60 min before bed. Dimming the lights sends a message to the brain to begin preparing for sleep and can be <span style="text-decoration: underline;">very</span> helpful. Avoid stressful, stimulating activities or discussing emotional issues. Physically and psychologically stressful activities can impair your ability to fall asleep. </p>
<p>5. Use Light to Your Advantage.</p>
<p>Natural light keeps your internal body clock on time and that makes for a healthy sleep-wake cycle. In general, it should be light when you want to be awake, and dark when you want to be asleep. Also, avoid bright light or computer screens (they can be relatively bright as they are close to your eyes) in the 2 hours before your usual bedtime because bright light during these 2 hours can fool your body clock and shift your sleep cycle later, and make it difficult to fall asleep. Don&rsquo;t underestimate the effect of light on sleep. It has been proven in many medical studies over the past 30 years to be the most powerful external time cue for your body clock. </p>
<p>6. Napping can be <a href="https://intermountainhealthcare.org/blogs/2015/09/sleeping-to-improve-your-health">Helpful</a> or Problematic.</p>
<p>Many people make naps a regular part of their day. However, for those who find falling asleep or staying asleep through the night challenging, afternoon or evening napping may be one of the reasons for the trouble. This is because late-day naps lower your sleep drive. If you must nap, it&rsquo;s better to keep it short (less than 20 minutes) and before 5 p.m. If you need to nap for safety reasons (like driving), then by all means do so regardless of the time &ndash; but consider consulting your doctor if it continues.</p>
<p>7. Go Easy on the Evening Meals.</p>
<p>Finish eating several hours before bedtime and avoid foods that cause indigestion. If you get hungry at night, snack on small amounts of food that (in your experience) won't disturb your sleep. Eating in the middle of the night is strongly discouraged because it is rewarding for the brain and will train your brain to wake you up each night! To break the vicious cycle, gradually reduce the amount of food, and the tastiness of the food, over time, so that eventually you are down to just a few sips of juice or water. Then it is easier to stop all together. </p>
<p>8. Balance Fluid Intake.</p>
<p>Drink enough fluid at night to stay hydrated and prevent waking up thirsty, but not so much and so close to bedtime that you will be awakened by the need for a trip to the bathroom. If you still notice a problem, consider seeing your doctor because certain medical conditions (like sleep apnea, diabetes, or prostate problems) can be the underlying reason. </p>
<p>9. Exercise at Consistent Levels.</p>
<a href="https://intermountainhealthcare.org/blogs/2015/06/how-to-get-started-with-your-own-exercise-plan">Regular exercise at levels that match a persons level of fitness</a> have been shown to help sleep and generally promote good health. Strenuous exercise (i.e. exercise at levels greater than a persons fitness level) can worsen sleep. Also, if the exercise (or shower/bath after the exercise) raises the core body temperature it can make it harder to fall asleep. So you may benefit from avoiding exercise right before bedtime. Try out various times and see which works best&nbsp;<br />
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</div>Wed, 07 Dec 2016 00:00:00 -0700{8A7D5367-93E5-4D87-85DB-C0B607BE2E4A}https://10.40.239.129/blogs/2016/12/3-things-vulnerability-can-show-us-about-the-power-of-giving-thanks/3 Things Vulnerability Can Show us About the Power of Giving ThanksIt's all about perspective. On a June day in 2011 my wife and I found ourselves at University Hospital in T&uuml;bingen, Germany at the bedside of our oldest son.&nbsp; While traveling in the Southern region of the country, Alex fell and suffered a traumatic brain injury.&nbsp;
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<div>As physicians, Mary Carole and I understood the situation was dire &mdash; very few patients survive or fully recover from this serious condition.&nbsp; As a family, we were terrified, worried, and completely vulnerable. Alex's life hung in the balance, far from home in the hands of a team of caregivers in a foreign country.
<div>&nbsp;
<p>From the bystander who found him, to the ambulance crew who transported him, to the neurosurgeon who operated on him, the care was spectacular. The system worked. He's now a thriving first year medical student, and his recovery will remain one of the greatest gifts our family will ever receive. </p>
<p>As frightening as times like these are in our lives, they teach us the power and promise of gratitude. </p>
<h3>Here are three things difficult experiences have taught me:</h3>
<p>
</p>
<ul>
<li>First, it's when we're vulnerable we most fully understand we can't do it alone. We see our connection to others and more fully appreciate their skills, talent, and dedication. (In fact, my son's neurosurgeon, Professor Florian Roser, followed me to Cleveland Clinical Abu Dhabi where he is now Chief of Neurosurgery.)&nbsp;</li>
<li>Second, vulnerable situations teach us to take help, not just give it. That's humbling, and not always easy.&nbsp;</li>
<li>And third, feeling profoundly grateful makes us want to pay it forward. We deepen our resolve to be there for those who need us.</li>
</ul>
<p>We&rsquo;re all going to face some tough times.&nbsp; To the extent they help us better connect to others, learn how to accept help from others, and give us the drive to pay it forward&mdash;those times make us stronger and deepen our humanity. &nbsp; &nbsp;</p>
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</div>Wed, 07 Dec 2016 00:00:00 -0700{04F4090F-7515-4865-987D-0B01179D9D5E}https://10.40.239.129/blogs/2016/12/what-is-asthma/What is Asthma?<p style="background: white;">Gardiner says mild asthma may feel like a shortness of breath, but an asthma "attack" has three major components:</p>
<ol>
<li>Inflammation that causes the airway to swell.&nbsp; This swelling makes the airway smaller, making it more difficult for the air to pass in and out of the lungs.</li>
<li>Airways have muscle bands around them, and during an attack these muscles tighten, making the airways even more narrow.&nbsp; This is called bronchoconstriction or sometimes it's called bronchospasm.</li>
<li>Airways also produce more mucus, which blocks an already narrowed airway.</li>
</ol>
<p>&ldquo;Several things can cause an asthma attack, and it can be different for everyone,&rdquo; said Gardiner. She explained the most common causes include:</p>
<ul>
<li>Infection--colds, flu, other illnesses</li>
<li>Irritants--smoke, air pollution, fumes</li>
<li>Allergens--dust mites, pollens, molds, animal dander, allergies to foods, cockroach droppings</li>
<li>Cold weather</li>
<li>Stress caused by emotions</li>
<li>Medications</li>
<li>Exercise</li>
</ul>
<p>Gardiner says it is important to be seen by a doctor if you suspect asthma. Besides making an official diagnosis, medical professionals can help patients to create an action plan of how to avoid triggers and treat attacks. In some cases, medications can be required.</p>
<p>To learn more about asthma, what treatments and services are available, go to <a href="https://intermountainhealthcare.org/services/respiratory-care/conditions/asthma/" target="_blank">https://intermountainhealthcare.org/services/respiratory-care/conditions/asthma/</a>. </p>
<p>Do you have other questions about asthma?&nbsp; , Intermountain Healthcare and KUTV 2 will be holding &ldquo;Ask The Expert&rdquo; on Tuesday, December 13th.&nbsp; Medical experts will answer questions about asthma during interviews on air and over the phone with callers from noon to 5:30 p.m.&nbsp; Those interested can call 877-908-0680 to speak free of charge to one of the Intermountain experts, including doctors, nurses, respiratory therapists, and other medical professionals, or receive answers via Facebook or Twitter using #kutvasktheexpert.</p>Wed, 07 Dec 2016 00:00:00 -0700{045C86FD-B691-4459-A230-E6C62AE02FB9}https://10.40.239.129/blogs/2016/12/treating-patients-as-human-beings/Treating Patients as Human BeingsThese patients and families look to their clinicians and caregivers to provide them with lifesaving medical care. But they also look to them for information, reassurance and compassion. Unfortunately, they don&rsquo;t always receive it.
<p>In fact, even while patients are being provided with high quality technical care, they are often dehumanized in subtle ways &mdash; stripped of their clothing; called by their condition rather than their name; subjected to tests and exams they don&rsquo;t understand, by doctors they don&rsquo;t know.</p>
<h3>Why does dehumanization happen? What is the impact on patients? How can we create change?</h3>
<p>Finding answers to these questions is what motivates Dr. Samuel Brown, director of the <a href="https://intermountainhealthcare.org/research/areas-of-research/clinical-research/center-humanizing-critical-care/" target="_blank">Center for Humanizing Critical Care</a> at Intermountain Healthcare. </p>
<p>The Center brings researchers and clinicians together to focus on helping patients and family members make it through life-threatening illnesses and injuries with their humanity and dignity intact. </p>
<h3>How Medical Dehumanization Happens</h3>
<p>Dehumanization happens when you deny people&rsquo;s human qualities, such as personality, reasoning and spirit. Extreme cases of dehumanization occur during war or genocide, and these are often deliberate. However Dr. Brown has found through research that most dehumanizing acts in medical settings occur unintentionally. </p>
<p>An overwhelming majority of health care professionals are caring people who are committed to helping others. That is why they have chosen a medical career. But being a clinician often requires complicated analytical thinking. And awareness of a patient&rsquo;s humanity may become a distraction that affects their ability to do their job.</p>
<p>Additionally, some critical care professionals unconsciously &ldquo;turn off&rdquo; their empathy and dehumanize patients to protect themselves from sadness associated patients patients&rsquo; death, a distressingly common outcome from an intensive care unit stay. This psychological shield may enable some medical providers to continue to care for critically ill and dying patients day after day. </p>
<p>Dr. Brown&rsquo;s primary goal is to develop approaches to critical care that acknowledge and respect patients as human beings, while still protecting caregivers from added stress and burn out. </p>
<p><strong>RELATED: </strong><a href="https://intermountainhealthcare.org/blogs/2014/10/improving-patient-care-in-hospital-intensive-care-units" target="_blank">Improving Patient Care in Intensive Care Units&nbsp;</a></p>
<h3>The Impact on Patients and Families</h3>
<p>Many commonly accepted critical care treatment practices result in unintentional psychological harm and suffering. Patients may feel abandoned, disillusioned, and confused. Many recovered ICU patients experience levels of PTSD similar to those of combat veterans. </p>
<p>The impact is physical as well as psychological, and can affect the patient&rsquo;s outcome and ability to heal. </p>
<h3>Bringing Humanity Back</h3>
<p>There are no simple solutions to changing the culture of ICU patient care, and further research needs to be done. But under Dr. Brown&rsquo;s leadership, Intermountain has already taken steps toward improvement. </p>
<p>Dr. Brown encourages medical practitioners to observe what he calls &ldquo;The Dinner Party Rule,&rdquo; treating each patient like he or she is the respected host of a dinner party. These basic guidelines include:</p>
<ul>
<li><strong>Knock before entering.</strong> This simple gesture offers patient&rsquo;s some control over their personal space and privacy. Providers should avoid entering a patient&rsquo;s hospital room or hospital bay without knocking (or asking permission) first. </li>
<li><strong>Ask what a patient would like to be called.</strong> Learning what a patient wants to be called is an important part of acknowledging them as an individual. Providers should first address a patient by the respectful title of Mr. or Mrs., followed by their last name. Then, they should ask the patient what name he or she would like to be called. </li>
<li><strong>Treat coma patients as if they are listening.</strong> Although some providers feel awkward talking to coma patients, it is important to treat them as though they are awake, by asking permission to touch them and addressing them appropriately. </li>
</ul>
<h3>Call the Experts </h3>
<p>Physicians don&rsquo;t hesitate to call experts to help solve a medical problem. The same principle should apply to the more personal aspects of care. At Intermountain, the &ldquo;experts&rdquo; on an individual patient&mdash; their loved ones&mdash;are involved in numerous stages of patient care, from life support to physical therapy. The result is improved patient engagement, better morale, and better outcomes.</p>
<h3>Finding Balance</h3>
<p>On an ongoing basis, one of the challenges of making critical care medicine human is finding the appropriate balance. Patients should be treated humanely and with dignity, while medical providers need to psychologically care for themselves so they can continue to do their jobs. </p>
<p>Dr. Brown believes that the answer lies within our ability as humans to empathize. By tapping into their human capacity to think, to care and to honor, medical professionals can begin to find the balance they need to provide respectful, high-quality critical care.&nbsp;</p>
<p>
<iframe width="560" height="315" src="https://www.youtube.com/embed/_9yS-u1Ucqg" frameborder="0"></iframe>
</p>Mon, 05 Dec 2016 00:00:00 -0700{6E347F20-AA88-45FF-A81F-B7CFB778C4D5}https://10.40.239.129/blogs/2016/12/how-to-improve-your-quality-of-life-during-a-serious-illness/How to Improve your Quality of Life During a Serious Illness<h3>What is Palliative Care?</h3>
<p>&nbsp;Palliative care (pronounced pal-lee-uh-tiv) is an approach to medical care for chronically and seriously ill patients and is focused on improving quality of life. It is provided by a team of specialists that includes: doctors, advanced practice clinicians, physician assistants, care managers, social workers, nurses and chaplains. This team works together with a patient and their loved ones to identify stressors caused by an illness. Palliative care is provided at different levels and involves your symptom management and discussions with your healthcare team. For example, if you are seeing an oncologist and they start a medication for pain related to your cancer, this is primary palliative care. Secondary palliative care is a consultation service with specially-trained and certified team members to help with more complicated symptoms or discussions. Palliative care teams work in the clinic, in a hospital or in a home setting. The palliative care team is a consult service, which means you will still see your other doctors. The palliative care team works with all your medical providers and will help coordinate services with them. </p>
<h3>Symptom Management</h3>
<p> There are two parts to a palliative care consult. The first part is symptom management. This includes symptom assessment provided by the palliative care team. Some commonly-treated symptoms include pain, shortness of breath, nausea and anxiety. The goal is to control these symptoms and improve the patient&rsquo;s quality of life by allowing the patient to function better. For example, patients with heart failure often experience shortness of breath when walking. This makes it difficult to get the mail or go to the grocery store. Sometimes patients even have trouble walking from room to room in their own homes. Patients commonly have the goal of remaining in their own home, which can become more and more difficult as their disease progresses. The palliative care team works together to develop a plan for the patient with steps to follow when shortness of breath occurs. The hope is that controlling shortness of breath will allow patients to regain the ability to walk longer distances, which in turn will allow them to do more when they are at home. It also improves the quality of patients&rsquo; time with their families by allowing them to not worry as much about their breathing. </p>
<h3>Goals of Care</h3>
<p> The second part of a palliative care consult includes discussions about a patient&rsquo;s goals of care. It is important for every member of the palliative care team to learn about what a patient wants for their personal life. These hopes and goals should drive the medical plan and level of medical intervention for a disease process. An illness can change what we hope for in our personal lives. In addition, different stages of illness usually affect one&rsquo;s body differently and can affect one&rsquo;s goals. For example, a patient may function pretty normally with minimal symptoms in the early stages of heart failure but lose a lot of strength in later stages. These changes in health lead people to reassess who they are and what they can do. No matter the stage of illness, the medical team should know what motivates a patient to keep pursuing medical care. Some patients have very aggressive and life-prolonging goals; others are more focused on comfort or staying out of the hospital. Discussing these goals allows for personalization of medical care. The palliative care team provides a supportive environment for these discussions. The palliative care physician will provide guidance on appropriate medical interventions for a specific stage of disease, but the final decisions regarding medical treatments are left up to the patient. The palliative care team does not have an agenda, and is always respectful of what a patient and their family chooses. </p>
<h3>When should goals of care discussions start?</h3>
<p> It is never too early to talk about goals of care. It would be ideal for people to start having discussions with their healthcare providers and loved ones at the time of diagnosis. Different people have different reactions when bringing up goals of care discussions. These discussions often make people nervous because they feel that the medical team is trying to talk about their deaths. In reality, these discussions are more focused on how a person wants to live and what is giving their life quality. The palliative care team helps people maintain quality while living with their chronic illness. </p>
<p>You can read some examples of common goals and issues below: </p>
<h4>Common medical goals</h4>
<p>&nbsp;&bull; Cure of disease </p>
<p>&bull; Prolonged life </p>
<p>&bull; Improved physical function </p>
<p>&bull; Decreased number of hospitalizations </p>
<p>&bull; Avoiding suffering when death is approaching </p>
<h4>Common personal goals</h4>
<p> &bull; Not becoming a burden on family </p>
<p>&bull; Spending more time doing hobbies and household work </p>
<p>&bull; Staying in own home or place of residence </p>
<p>&bull; Attending specific events such as weddings, graduations and family vacations </p>
<p>&bull; Maintaining control in things like driving, finances and making decisions </p>
<h4>Common issued included in goals of care discussions</h4>
<p>&nbsp;&bull; What to expect in the future with a specific disease process (cancer, heart failure, COPD, etc.) </p>
<p>&bull; What is giving the patient life quality right now? </p>
<p>&bull; What does the patient enjoy doing during the day? </p>
<p>&bull; What is patient looking forward to in the future? </p>
<p>&bull; Are there events or dates that are important to the patient? </p>
<p>&bull; Are there activities that the patient must be able to do in order for life to feel worth living? </p>
<p>&bull; What would the patient want in the event of a &ldquo;code blue&rdquo; situation? </p>
<p>&bull; What level of medical intervention would the patient want if they were admitted to the hospital? </p>
<h4>Documenting Goals of Care</h4>
<p> After discussing goals of care with the patient, the palliative care physician works with the patient to translate their stated wishes into a medical plan. This is communicated with the rest of the medical team by completing advanced directives. </p>
<p>In the state of Utah, the most important advanced directives to complete are a Medical Power of Attorney and a POLST (Physician Order for Life Sustaining Treatment) form. A POLST form tells your medical team how intense you want your medical care to be should you become ill. A Medical Power of Attorney is a form on which a patient can choose who will speak on their behalf if they cannot speak for themselves. </p>Mon, 05 Dec 2016 00:00:00 -0700{21D269A7-53A9-4967-B5AA-A95B7DB2673B}https://10.40.239.129/blogs/2016/12/8-faqs-about-the-breast-cancer-gene/8 FAQS about the Breast Cancer Gene<p>Breast cancer patients, many of whom are mothers, wonder what the disease will mean for their daughters and other family members. My patients are often concerned that they passed on &ldquo;the breast cancer gene&rdquo; to their children. I&rsquo;d like to help you understand how genetics affect breast cancer so you and your family can find answers and stay healthy.&nbsp;</p>
<h3>WHAT IS THE BREAST CANCER GENE?</h3>
<p>The BRCA1 and BRCA2 genes, when functioning normally, produce proteins that suppress tumor production, so they actually protect you from getting certain types of cancer. It is mutations (changes) in these genes that increase your risk of getting certain types of cancer&mdash;most commonly breast and ovarian cancers. These dangerous mutations can be inherited, but only 5 &ndash; 10% of women with breast cancer have these mutated BRCA genes.&nbsp;</p>
<h3>&nbsp;WHO SHOULD BE TESTED FOR BRCA MUTATIONS?</h3>
<p>Mutations like the BRCA1 and BRCA2 are very uncommon. It is estimated that only 1 in 400 or 1 in 800 women in the general public have one of these significant BRCA mutations. Studies have found there are risk factors that can increase the chances of having a BRCA mutation. However, even people with these risk factors only have a 15 &ndash; 20% chance of having a BRCA mutation. People with these risk factors can be tested to see if they have a mutation. Many insurance companies will cover the cost of these tests, which are considered to be preventative care for high-risk patients.&nbsp; </p>
<h3>RISK FACTORS FOR BRCA GENE TESTING</h3>
<p>&bull; A first or second-degree relative who was diagnosed with breast cancer before the age of 50. Any male first or second-degree relative diagnosed with breast cancer.&nbsp;</p>
<p>&bull; 2 or more breast cancers in the same first or second-degree relative. 2 or more relatives on the same side of the family with breast cancer.&nbsp;</p>
<p>&bull; Breast cancer and ovarian cancer in the same first or second-degree relative or in family members on the same side of the family. A family member diagnosed with triple-negative breast cancer before age 60.</p>
<p>&bull; A first or second-degree relative with a known mutation of BRCA. </p>
<h3>HOW DO I GET TESTED?</h3>
<p>Genetic testing can be ordered by a physician or through a genetic counselor. It is often better to have the family member with breast or ovarian cancer tested first, since they are more likely to have the BRCA mutation. If they don&rsquo;t have the BRCA mutation, they could not pass it on to anyone else. Keep in mind that these tests are complicated and don&rsquo;t always give simple answers. Everyone&rsquo;s genes are a little different, so there could be variances that you won&rsquo;t understand. Your test results could show a variation from normal that may still be &ldquo;normal.&rdquo; This is why it is important to speak with a physician or genetic counselor prior to and while reviewing genetic test results. He or she can help you pick the right test based on your family history and explain the results to you.&nbsp; </p>
<h3>WHAT IF I DO HAVE A HARMFUL MUTATION?</h3>
<p>First, know that this does not mean you will get cancer. While your risk of developing cancer with one of these mutations is higher than that of the general population, it is not 100 percent. The table below lists the risk for developing breast or ovarian cancer, and this information changes as data continues to come in. There are ways to decrease risks for getting cancer, and close monitoring that can be done to catch cancers in early stages. The care options you choose are incredibly personal. Recently, I counseled a 17-year-old girl about the BRCA gene mutation and what that meant for her. That was a very different discussion from the one I had with a 60-year-old grandmother who had taken the test to get information to help her children. Prevention strategies come from a spectrum of options that include frequent exams, MRIs and medications. It may even be necessary to remove breast tissue and ovaries with surgery, which can nearly eliminate the risk of breast and ovarian cancer. It is important to review your options with a physician so you can make an informed decision that is right for you.&nbsp; </p>
<h3>RISK OF DEVELOPING CANCER BY THE AGE OF 70&nbsp;</h3>
<p>BRCA1 &mdash;Breast Cancer:55 - 65%</p>
<p> BRCA1 &mdash;Ovarian Cancer: 39%&nbsp;</p>
<p>BRCA2 &mdash;Breast Cancer: 45%</p>
<p>BRCA2 &mdash;Ovarian Cancer: 15% &nbsp;</p>
<h3>IF I DON&rsquo;T HAVE THE BRCA MUTATION, DOES THAT MEAN I CAN&rsquo;T GET BREAST CANCER?</h3>
<p>Unfortunately, no. 90 &ndash; 95% of women with breast cancer and 85% of women with ovarian cancer do not have mutations in their BRCA genes. The lifetime risk for the general population to develop breast cancer is about 12%, and the risk for developing ovarian cancer is 1.3%. However, there are things you can do that have been shown to decrease the risk of breast cancer.&nbsp;</p>
<h3>ACTIVITIES AND CONDITIONS: </h3>
<p>MODERATE EXERCISE Decreases by 15 &ndash; 25%&nbsp; </p>
<p>ESTROGEN / PROGESTERONE HORMONE REPLACEMENT THERAPIES: Increase risk of breast cancer by 25%&nbsp; </p>
<p>DRINKING ALCOHOL: More than 3 or 4 alcoholic drinks per week INCREASES risk of breast cancer by 15%&nbsp; </p>
<p>BREASTFEEDING: DECREASES risk of breast cancer&nbsp; </p>
<p>TOBACCO USE: INCREASES risk of breast cancer OBESITY: INCREASES risk of breast cancer&nbsp; </p>
<p>RADIATION: INCREASES risk of breast cancer&nbsp;</p>
<h3>KNOWLEDGE IS POWER</h3>
<p>Breast cancer can be intimidating, but I hope this discussion has eased your mind. Don&rsquo;t be afraid to ask your doctor any questions. Understanding BRCA mutations, diagnostic tests and cancer prevention measures will help you and your family stay well and happy. </p>
<p><strong>Learn more about the Breast Cancer gene here: </strong></p>
<p>&nbsp;</p>
<iframe height="360" marginheight="0" src="http://kutv.com/embed/news/2news-this-morning/ask-the-expert-reducing-risk-of-breast-cancer?external-id=648ddd21e3c64e95b123d2e98b66ad9a" frameborder="0" width="640" marginwidth="0"></iframe>Fri, 02 Dec 2016 00:00:00 -0700{2C033268-8FC5-46CE-AD40-D4E9CA80D993}https://10.40.239.129/blogs/2016/12/should-doctors-prescribe-exercise/Should Doctors Prescribe Exercise?<p>Maintaining a healthy weight and being physically active is vital to reducing health risks and maintaining or even avoiding chronic conditions.&nbsp; </p>
<p>Liz Joy, MD, Intermountain&rsquo;s Medical Director for Community Health and Clinical Nutrition, presented this information at the 2016 American Heart Association Scientific Sessions in New Orleans. Her primary message: Every patient should get a physical activity assessment and prescription at their doctor&rsquo;s visit.</p>
<p>At Intermountain Healthcare, physical activity assessments (Physical Activity Vital Sign &ndash; PAVS) are built into the electronic health records of patients. Physicians can ask the patient during an appointment how much activity they get during a week, the intensity, and correlate that information with their patient&rsquo;s health.</p>
<p>&ldquo;Then with that information, we can give advice to start, increase or maintain activity,&rdquo; Dr. Joy said.</p>
<p><strong>RELATED</strong>: <a href="https://intermountainhealthcare.org/blogs/2013/03/get-moving-what-s-your-physical-activity-vital-sign" target="_blank">Get Moving! What&rsquo;s Your Physical Activity Vital Sign?</a></p>
<p>Inactivity can lead to major health problems such as with heart disease, higher stroke risk and type 2 diabetes &ndash; just to name a few. The recommendation is 150 minutes of moderate intensity physical activity each week (or 75 minutes per week of vigorous activity), which equates to about 30 minutes of moderate intense activity, five days a week. Adding some strength training two times per week adds even more benefits!</p>
<p>Hear more from Liz Joy on the need for physicians to monitor physical activity in the video below. </p>
<iframe width="640" height="360" src="https://www.youtube.com/embed/hDzSmcFnXKk?rel=0&amp;controls=0&amp;showinfo=0" frameborder="0"></iframe>Thu, 01 Dec 2016 00:00:00 -0700{4B1FB1C6-494D-46F2-9CBA-C27807563BB9}https://10.40.239.129/blogs/2016/11/25-days-of-christmas/25 Days of Christmas<ul>
<li>December 1 &ndash; Make a paper countdown chain</li>
<li>December 2 &ndash; Christmas movie and popcorn</li>
<li>December 3 &ndash; Family game night</li>
<li>December 4 &ndash; If possible, go for a winter walk</li>
<li>December 5 &ndash; Drive around to see neighborhood lights</li>
<li>December 6 &ndash; Sing Christmas carols</li>
<li>December 7 &ndash; Make ornaments</li>
<li>December 8 &ndash; Hot chocolate and play cards</li>
<li>December 9 &ndash; Sit by a warm fire</li>
<li>December 10 &ndash; PJ&rsquo;s and pancakes</li>
<li>December 11 &ndash; Make gingerbread cookies</li>
<li>December 12 &ndash; Write a letter to a friend</li>
<li>December 13 &ndash; Make paper snowflakes</li>
<li>December 14 &ndash; Write letters to Santa</li>
<li>December 15 &ndash; Enjoy peppermint sundaes</li>
<li>December 16 &ndash; Call an old friend</li>
<li>December 17 &ndash; Make a Christmas card for someone special</li>
<li>December 18 &ndash; Christmas word search</li>
<li>December 19 &ndash; Color a Christmas coloring book</li>
<li>December 20 &ndash; Take a bath and listen to Christmas music</li>
<li>December 21 &ndash; Christmas puzzle</li>
<li>December 22 &ndash; Read Christmas books</li>
<li>December 23 &ndash; If possible, help wrap Christmas presents</li>
<li>December 24 &ndash; Read &ldquo;The Night before Christmas&rdquo; book </li>
<li>December 25 &ndash; Enjoy Christmas day with family</li>
</ul>
<p style="margin: 0in 0in 8pt;">From all of us at Intermountain Precision Genomics, we wish you and your family a happy holiday season! </p>Wed, 30 Nov 2016 00:00:00 -0700{F5479D65-9BEB-459E-B789-54F635B059D5}https://10.40.239.129/blogs/2016/11/5-tips-for-surviving-family-stress-during-the-holidays/5 Tips for Surviving Family Stress During the Holidays<p>During the holidays, a lot of families get together for food, fun, reminiscing­ &mdash; and maybe a touch (or more) of drama. Holiday gatherings can be stressful as old memories &mdash; good and bad &mdash; rise to the surface.</p>
<p>We&rsquo;re typically busier during the holidays than we are at any other time of the year. This means stress levels are higher and we&rsquo;re more likely to be upset by smart remarks, teasing, and negativity. In the midst of kids fighting, siblings sharing stories you wish everyone had forgotten, or family members engaging in behavior that drives you up the wall, you might ask yourself "Why is my family so &lsquo;out there?&rsquo;"</p>
<p>Here are some tips to survive the holiday season with your family:</p>
<ol>
<li><strong>Don&rsquo;t sweat the small stuff</strong>. Don't give any more mileage to bad feelings. If you have some bad feelings about others, acknowledge those feelings are there, and maybe for a good reason, but decide not to let them grow.</li>
<li><strong>Set healthy boundaries</strong>. If there are things you&rsquo;d set limits on with others at any other time of the year, set them during the holidays. Healthy boundaries will help reduce stress and give you a sense of control over your environment.</li>
<li><strong>Be sensitive to those around you</strong>. Statistically speaking, one in five people will suffer from a mental health condition this year in the U.S. In fact, Utah has the nation&rsquo;s highest rate of mental illness. A lot of people struggle with the holidays &mdash; and they might be family members who don't want to talk about the extra stress or sadness they&rsquo;re feeling. But be aware that the holidays can be especially stressful for some people, and be on the lookout to help someone around you.</li>
<li><strong>Have realistic expectations</strong>. Here&rsquo;s the thing about families: You know a lot about each other &mdash; the good and the bad. Avoid the temptation to make a case against those who bother you and make an effort to see their strengths in addition to their weaknesses in order to keep a balanced view. Remember this: Everyone has something they&rsquo;re battling.</li>
<li><strong>There&rsquo;s some very real pain out there</strong>. If you find yourself in an emotionally abusive situation, you need to look for a healthier place to be. Families can come in all forms, so if relatives are distanced from one because of abuse or trauma, find your "family" with people who enhance your health and well-being.</li>
</ol>Wed, 30 Nov 2016 00:00:00 -0700